title: Preparedness planning before mechanical circulatory support: a "how-to" guide for palliative medicine clinicians.
abstract: The role of palliative medicine in the care of patients with advanced heart failure, including those who receive mechanical circulatory support, has grown dramatically in the last decade. Previous literature has suggested that palliative medicine providers are well poised to assist cardiologists, cardiothoracic surgeons, and the multidisciplinary cardiovascular team with promotion of informed consent and initial and iterative discussions regarding goals of care. Although preparedness planning has been described previously, the actual methods that can be used to complete a preparedness plan have not been well defined. Herein, we outline several key aspects of this approach and detail strategies for engaging patients who are receiving mechanical circulatory support in preparedness planning.
authors.affiliation: Division of General Internal Medicine, Section of Palliative Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: swetz.keith@mayo.edu.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Swetz
authors.affiliation: Duke University, Durham, North Carolina, USA.
authors.forename: Arif H
authors.initials: AH
authors.lastname: Kamal
authors.affiliation: University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Matlock
authors.affiliation: Department of Nursing, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Dose
authors.affiliation: Division of General Internal Medicine, Section of Palliative Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Lynn S
authors.initials: LS
authors.lastname: Borkenhagen
authors.affiliation: Division of General Internal Medicine, Section of Palliative Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Ashley K
authors.initials: AK
authors.lastname: Kimeu
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Dunlay
authors.affiliation: Division of General Internal Medicine, Section of Palliative Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Molly A
authors.initials: MA
authors.lastname: Feely
mesh_terms: D032722:Advance Care Planning / Q000941:ethics; D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D003657:Decision Making; D004868:Equipment Failure; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects; D006801:Humans; D007258:Informed Consent; D008297:Male; D010166:Palliative Care / Q000941:ethics / Q000379:methods*; D065126:Palliative Medicine / Q000941:ethics / Q000379:methods*; D010820:Physicians / Q000941:ethics; D011788:Quality of Life
keywords: Mechanical circulatory support; advance care planning; end of life; medical ethics; palliative care; preparedness planning; ventricular assist device